Sandra Kastantin, MA CCC-SLP

Describe treatment approach used: I look at a child's whole system. Depending on the motor sub-system I have determined should be the starting point (i.e., jaw, lips, tongue) I will engage a child in play utilizing target syllables, words, and/or functional phrases that are both inherent to success in that activity (making it functional) but at an appropriate level of motor-speech complexity (as well as language and play levels) that is consistent across sessions until the movement pattern is solid. In this way, a child can practice a core pattern of movement repeatedly while also feeling the timing needed within a conversational exchange, and being motivated inherently to communicate in order to enjoy the activity. For example, if a child is working on vowel-consonant production and learning to bring his/her jaw from open to closed consistently, he/she may work on words such as "up" while playing a game shooting butterflies 'up' in the air. He/she then is encouraged to use 'up' when asking a parent to pick him/her up in order to practice generalizing this same pattern. I like to practice this target pattern during structured 'mass practice' for 5-10 minutes before using it in a game as described above.

Describe parent/caregiver involvement: Parents are provided with functional words and phrases to practice during routine activities at home. In this way, they are able to have more spontaneous interactions with their child throughout the day while staying within a child's range of movement planning capability. They are given ideas for play in which to practice these targets as well. Target words and phrases are always consistent with patterns being worked on in session. Parents are also provided with strategies for eliciting and reinforcing language expression as well as positive play/engagement behaviors.

Describe your past and current involvement in the Apraxia community​?​ I first treated Apraxia while working in adult neuro-rehabilitation programs. I became involved with CAS as a practitioner at a private practice specializing in PROMPT. While working at that practice, I provided extensive education to parents and watched children progress in their ability to engage while simultaneously decrease negative behaviors. I follow the Apraxia Kids facebook page and have occasionally contributed to answering questions. I have moved to a new area (Boston) and am beginning a new practice of my own. I will continue to grow in my involvement with the community as I am able.